My confession: I love histories of common objects that show their evolution over time, connecting the random dots of adjacent possibilities. Connections by James Burke is a favorite . So today I pay homage of sorts to that seemingly random walk through thoughts and origins

My disclaimer: I am lapsed disruptive physician or at least I like to believe that my ‘disruption’ these days is more geared toward innovation and change rather than berating and frustration.

Several years ago I was asked to counsel a colleague who had initiated a screaming match at the med-surg nursing station. The incident was shared with me by another colleague who was, in fact, a member of medical leadership. So why had they not intervened at that moment, why had they remained a Bystander? Why had they not become an Upstander? Now Upstander for me is a new word, developed in the bullying literature (disruptive behavior is in part about bullying). Here is a definition:

Upstander is … used to identify people who are willing to stand up and take action in defense of others. It can refer to individuals who take large risks during wars and political turmoil, and it also identifies people who take small but helpful steps to shield others from bullying and other injustices.

But I digress since my question is why people do not act when they see this type of ‘injustice’? I believe the underlying reason is agency, more commonly applied as a noun but used here as a verb. And in searching for agency with Google I went down the rabbit hole to find that I had inadvertently stumbled upon a key sociologic question.

Structure and agency forms an enduring core debate in sociology. … "agency" refers to the capacity of individuals to act independently and to make their own free choices, whereas "structure" refers to those factors (such as social class… subculture, etc.) that seem to limit or influence the opportunities that individuals have.

So there it is, the reason the Bystander is not an Upstander is because they do not feel empowered to act, they lack agency; and why do they remain a noun instead of a verb? Because of the culture that influences them to suppress the more human response, especially for healthcare workers, to show concern and support.And that let me to consider how structure is reflected in our language, in our nouns and verbs. And so I looked at two more noun verb ‘dualities’ that had interested me, curate and cultivate. And for both, I found a bifurcated past. Cultus is Latin for ‘care directed at life’ and gives us both the German noun, Kultur and the English verb, cultivate-to nurture. Curo is Latin for ‘heal or cure’ from which is derived the participle* curatus-healing, and from which we derive the noun, curator- guardian.

And this seemingly random walk brings us back to a question I have ask before, why are we nouns instead of verbs? Evidently it is a law of linguistics as much as it is in physics (A body at rest remains at rest; a body in motion remains in motion.)

We need to be the verb; to cultivate rather than curate, to be an Upstander rather than Bystander.

*Participle modifies a verb, like an adjective modifies a noun. And yes, I cannot believe that I was ever able to use particle